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Strahlentherapie und Onkologie

, Volume 193, Issue 9, pp 683–691 | Cite as

High-dose-rate brachytherapy as salvage modality for locally recurrent prostate cancer after definitive radiotherapy

A systematic review
  • Georgios ChatzikonstantinouEmail author
  • Nikolaos Zamboglou
  • Claus Rödel
  • Eleni Zoga
  • Iosif Strouthos
  • Saeed Ahmed Butt
  • Nikolaos Tselis
Review Article

Abstract

Purpose

To review the current status of interstitial high-dose-rate brachytherapy as a salvage modality (sHDR BRT) for locally recurrent prostate cancer after definitive radiotherapy (RT).

Materials and methods

A literature search was performed in PubMed using “high-dose-rate, brachytherapy, prostate cancer, salvage” as search terms. In all, 51 search results published between 2000 and 2016 were identified. Data tables were generated and summary descriptions created. The main outcome parameters used were biochemical control (BC) and toxicity scores.

Results

Eleven publications reported clinical outcome and toxicity with follow-up ranging from 4–191 months. A variety of dose and fractionation schedules were described, including 19.0 Gy in 2 fractions up to 42.0 Gy in 6 fractions. The 5‑year BC ranged from 18–77%. Late grade 3 genitourinary and gastrointestinal toxicity was 0–32% and 0–5.1%, respectively.

Conclusions

sHDR BRT appears as safe and effective salvage modality for the reirradiation of locally recurrent prostate cancer after definitive RT.

Keywords

Side effects Salvage therapy Biochemical failure Toxicity scores Dose fractionation 

High-Dose-Rate-Brachytherapie als Salvage-Modalität beim lokal rezidivierten Prostatakarzinom nach definitiver Strahlentherapie

Ein systematischer Review

Zusammenfassung

Zielsetzung

Zusammenfassende Darstellung relevanter Literatur zur interstitiellen High-Dose-Rate-Brachytherapie als Salvage-Modalität (sHDR-BRT) bei der Behandlung des lokal rezidivierten Prostatakarzinoms nach vorausgegangener definitiver Radiotherapie (RT).

Material und Methoden

In der PubMed-Datenbank wurde eine Literaturrecherche mit den Suchbegriffen „high-dose-rate, brachytherapy, prostate cancer, salvage“ durchgeführt. Zwischen den Jahren 2000 und 2016 wurden 51 Publikationen identifiziert. Die biochemische Kontrolle (BC) sowie das assoziierte Toxizitätsprofil waren onkologische Hauptpunkte in der Analyse der berücksichtigten Literatur.

Ergebnisse

Von onkologischen Ergebnissen und Toxizitäten berichteten 11 Publikationen bei einer medianen Nachbeobachtungszeit von 4–191 Monaten. Eine Variabilität von Dosis- und Fraktionierungsregimen wurde beschrieben mit totalen physikalischen Dosen von 19,0 Gy in 2 Fraktionen bis zu 42,0 Gy in 6 Fraktionen. Die 5‑Jahres-BC lag zwischen 18 % und 77 % bei einer genitourinären und gastrointestinalen Spättoxizität Grad III von jeweils 0–32 % und 0–5,1 %.

Schlussfolgerung

Die sHDR-BRT ist eine sichere Modalität für die Rebestrahlung des lokal rezidivierten Prostatakarzinoms nach vorausgegangener definitiver RT.

Schlüsselwörter

Nebenwirkungen Salvage-Therapie Biochemisches Rezidiv Toxizitätsscores Dosisfraktionierung 

Notes

Conflict of interest

G. Chatzikonstantinou, N. Zamboglou, C. Rödel, E. Zoga, I. Strouthos, S.A. Butt and N. Tselis declare that they have no competing interests.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of Radiotherapy and OncologyJ. W. Goethe University of FrankfurtFrankfurt am MainGermany
  2. 2.Department of Radiotherapy and OncologySana Klinikum OffenbachOffenbach am MainGermany
  3. 3.Department of Radiotherapy and Oncology, Medical Center – University of FreiburgUniversity of FreiburgFreiburgGermany
  4. 4.Department of Medical Physics and EngineeringSana Klinikum OffenbachOffenbach am MainGermany

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